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Blair C, Leonard R, Linden M, Teggart T, Mooney S. Allied health professional support for children and young adults living in and leaving care: A systematic scoping review. Child Care Health Dev 2024; 50:e13140. [PMID: 37300280 DOI: 10.1111/cch.13140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/06/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Children and young people living in and leaving care are known to have experienced significant childhood adversity and trauma resulting in potentially deleterious impact on their health and well-being across the life course. Studies point to the complex needs of this population who may benefit from allied health professional (AHP)-related support with limited studies located. This review sought to address this gap by systematically scoping empirical literature focused on the provision of AHP support to this cohort of children and young adults to assist an understanding of the service needs for this vulnerable population. METHODS This scoping review followed Arskey and O'Malley's five steps framework (2005) to identify and review relevant literature. A focus on identifying the evidence, challenges and gaps in research relating to AHP support for children and young people living in and leaving care was initially agreed, followed by a systematic search using a combination of three key concepts to identify relevant studies in five AHP disciplinary areas to identify best evidence in the past decade (2011-2021). Study inclusion criteria were based on empirical studies of children and young people living in care (0-17 years) and leaving care (18-25 years). A data extraction table was formulated as a means of charting the data, aligned with the scope and objectives of this review. Finally, data were subsequently collated, synthesised and reported based on key thematic areas emerging from included studies regarding AHP support to children and young people living in and leaving care. RESULTS A total of 13 studies met the review inclusion criteria. Included studies reported specifically on speech and language therapist (SLT; n = 5), occupational therapist (OT; n = 3) and arts-based therapies (n = 5). No studies were identified with regard to the use of physiotherapy and dietetics with this population. Results indicated that children and young people living in and leaving care have high rates of speech, language, communication and sensory needs. More rigorous screening, assessment and early intervention were identified as essential for this vulnerable group. Increased multidisciplinary collaboration and OT support for young adults in preparation for transition to independent living was identified as an urgent requirement. Included studies indicate promising results in relation to access to arts-based therapies with particular reference to identity formation for children and young people living in and leaving care. CONCLUSIONS Although evidence of effectiveness remains limited, AHP service provision (specifically speech and language therapy, occupational therapy and arts-based therapies) has the potential to contribute positively to addressing the complex and interacting needs of this vulnerable population. As a result, it is recommended that AHP service provision is integrated into the collaborative, multidisciplinary care available to children living in and leaving care. More extensive, higher quality research related to the benefits of AHP provision for this population of children and young people is essential to provide a more robust evidence base across the various professional disciplines that constitute allied health provision.
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Affiliation(s)
- Carolyn Blair
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Rachel Leonard
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Mark Linden
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | - Suzanne Mooney
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
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Haune M, Nissen A, Christiansen Ø, Myrvold TM, Ruud T, Heiervang ER. Comprehensive Health Assessment for Children in Out-of-Home Care: An Exploratory Study of Service Needs and Mental Health in a Norwegian Population. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01619-5. [PMID: 37828418 DOI: 10.1007/s10578-023-01619-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 10/14/2023]
Abstract
A comprehensive model for routine multi-disciplinary health assessment for children in out-of-home care was piloted in a Norwegian region. This paper reports on identified service needs and mental disorders among 196 children (0-17 years) receiving the assessment. Cross-sectional data was extracted from assessment reports. Results show needs across a range of services, with a mean of 2.8 recommended services for children aged 0-6 and 3.3 for children aged 7-17. Mental disorders were identified in 50% of younger children, and 70% of older children. For all children, overall service need was associated with mental disorders, in addition to male gender among younger children. Need for specialized mental health services was associated with mental disorders among younger children and increasing age among older children. The high frequency of service needs and mental disorders illustrate the importance of offering comprehensive health assessments routinely to this high-risk child population and necessitates coordinated service delivery.
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Affiliation(s)
- Monica Haune
- Institute of Clinical Medicine, University of Oslo, Blindern, P.O box 1171, Oslo, 0318, Norway.
| | - Alexander Nissen
- Division for Forced Migration and Refugee Health, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Øivin Christiansen
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Trine M Myrvold
- Norwegian Institute for Urban and Regional Research, Oslo Metropolitan University, Oslo, Norway
| | - Torleif Ruud
- Institute of Clinical Medicine, University of Oslo, Blindern, P.O box 1171, Oslo, 0318, Norway
- Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Einar R Heiervang
- Institute of Clinical Medicine, University of Oslo, Blindern, P.O box 1171, Oslo, 0318, Norway
- Oslo University Hospital, Oslo, Norway
- Innlandet Hospital Trust, Innlandet, Norway
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McTavish JR, McKee C, Tanaka M, MacMillan HL. Child Welfare Reform: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114071. [PMID: 36360960 PMCID: PMC9655914 DOI: 10.3390/ijerph192114071] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 06/01/2023]
Abstract
While there have been ongoing calls to reform child welfare so that it better meets children's and families' needs, to date there have been no comprehensive summaries of child welfare reform strategies. For this systematic scoping review, we summarized authors' recommendations for improving child welfare. We conducted a systematic search (2010 to 2021) and included published reviews that addressed authors' recommendations for improving child welfare for children, youth, and families coming into contact with child welfare in high-income countries. A total of 4758 records was identified by the systematic search, 685 full-text articles were screened for eligibility, and 433 reviews were found to be eligible for this scoping review. Reviews were theoretically divided, with some review authors recommending reform efforts at the macro level (e.g., addressing poverty) and others recommending reform efforts at the practice level (e.g., implementing evidence-based parenting programs). Reform efforts across socioecological levels were summarized in this scoping review. An important next step is to formulate what policy solutions are likely to lead to the greatest improvement in safety and well-being for children and families involved in child welfare.
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Affiliation(s)
- Jill R. McTavish
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 293 Wellington Street North, Hamilton, ON L8L 8E7, Canada
| | - Christine McKee
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 293 Wellington Street North, Hamilton, ON L8L 8E7, Canada
| | - Masako Tanaka
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 293 Wellington Street North, Hamilton, ON L8L 8E7, Canada
| | - Harriet L. MacMillan
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, 293 Wellington Street North, Hamilton, ON L8L 8E7, Canada
- Department of Pediatrics, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
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Hickey L, Galvin K, Parolini A, Nguyen B, Lokmic-Tomkins Z, Toovey R, Skeat J, Wise S. The engagement of children in out-of-home care with nursing and allied health professionals: A scoping review. Child Care Health Dev 2021; 47:758-770. [PMID: 34250634 DOI: 10.1111/cch.12893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 02/04/2021] [Accepted: 07/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Children living in out-of-home care (OOHC) have significant unmet health care needs and use more tertiary and specialist health care services compared with children from similar social and economic backgrounds. Allied health professionals and nurses have a central role in health care; however, very little is known about the engagement of children in OOHC with nursing and allied health professionals. This scoping review addresses this knowledge gap. METHODS A scoping review methodology framework was used to search for relevant articles published between January 1970 and November 2019, identified using three databases: MEDLINE, CINAHL and ProQuest. Selection of studies was based on empirical research about the health of children in OOHC and their engagement with nursing or allied health services. A total of 37 relevant articles met the eligibility criteria for inclusion in this review. RESULTS Findings could be summarized under five broad themes: (1) nursing and allied health professionals engaging with children in OOHC to support their health and development, (2) opportunities and challenges for nursing and allied health professionals to engage children in OOHC in healthcare, (3) identification and complexity of healthcare needs, (4) access to healthcare services and (5) coordination of healthcare. CONCLUSIONS Children in OOHC have multiple healthcare needs that require monitoring and treatment by allied health professionals and the health and development of these children is best supported through comprehensive health screening on entry into OOHC, and community-based, multidisciplinary healthcare while children are living in OOHC. While nurses in hospitals and community settings were found to play a role in health assessment and care coordination targeted at children in OOHC, the literature was silent on the role of allied health professionals in this healthcare approach.
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Affiliation(s)
- Lyndal Hickey
- Department of Social Work, The University of Melbourne, Carlton, Victoria, Australia
| | - Karyn Galvin
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Arno Parolini
- Department of Social Work, The University of Melbourne, Carlton, Victoria, Australia
| | - Bao Nguyen
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Rachel Toovey
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.,Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Jemma Skeat
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sarah Wise
- Department of Social Work, The University of Melbourne, Carlton, Victoria, Australia
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Johansson N, Fängström K, Warner G. Social workers' perspectives on a medical home model for children and adolescents in out of home care - an interview study. BMC Health Serv Res 2021; 21:804. [PMID: 34384407 PMCID: PMC8359767 DOI: 10.1186/s12913-021-06737-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 07/05/2021] [Indexed: 11/21/2022] Open
Abstract
Background This study seeks to explore how social workers have perceived and experienced a medical home model for children and adolescents in out-of-home care in Uppsala County, Sweden. Method A qualitative explorative study was conducted, which involved ten semi-structured individual telephone interviews with social workers. The study sample included employees within the social service, working in a specialised case unit who had experience of referring children and/or adolescents to the medical home model called Hälsofam. Data were analysed inductively using thematic analysis. Results The findings of the current study indicated that working with Hälsofam has offered social workers a way into the health care sector and an active collaborative working situation, with focus on organised work across the ‘silos’ of care services. However, the findings raised the question of whether or not all children and adolescents have the same possibility to receive care from Hälsofam. Conclusion The findings indicated that the Hälsofam model had a positive impact on the interrelations between the social service and the health care sector. Yet, findings showed that personal views of the social worker and the societal situation in which they operate create limitations for providing care for every child and adolescent. This study adds to the extant literature for it addresses the limitations within the work of children and adolescents in out-of-home care. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06737-1.
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Affiliation(s)
- Nina Johansson
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, 751 22, Uppsala, Sweden.
| | - Karin Fängström
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, 751 22, Uppsala, Sweden
| | - Georgina Warner
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, 751 22, Uppsala, Sweden
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Bonati M, Tognoni G, Sereni F. Inequalities in the Universal Right to Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2844. [PMID: 33799530 PMCID: PMC8000877 DOI: 10.3390/ijerph18062844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 11/16/2022]
Abstract
Child health inequalities violate children's rights to optimal wellbeing. Different issues worldwide affect children's physical and mental health as well as their development, influencing their future as adults. Inequities are avoidable inequalities. Despite improvements in the past two decades, the ambitious goals of global agendas have, for the most part, remained as expectations with regard to childhood rights, social justice, and health equity in practice. The concept of social determinants of health has become part of the common language in certain settings, but this is still too little to improve health in practice on a global scale, particularly for underprivileged subgroups of the community, as children and adolescents often are. Pediatric health professionals and their organizations are also responsible for guaranteeing children's and adolescents' right to health and better wellbeing, helping to reduce health inequalities.
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Affiliation(s)
- Maurizio Bonati
- Laboratory for Mother and Child Health, Public Health Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
| | - Gianni Tognoni
- Dipartimento di Anestesia-Rianimazione e Emergenza Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Fabio Sereni
- Department of Pediatrics, University of Milan, 20122 Milan, Italy;
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Mensah T, Hjern A, Håkanson K, Johansson P, Jonsson AK, Mattsson T, Tranæus S, Vinnerljung B, Östlund P, Klingberg G. Organisational models of health services for children and adolescents in out-of-home care: Health technology assessment. Acta Paediatr 2020; 109:250-257. [PMID: 31483896 PMCID: PMC7003841 DOI: 10.1111/apa.15002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/13/2019] [Accepted: 09/03/2019] [Indexed: 01/08/2023]
Abstract
AIM Decades of research confirm that children and adolescents in out-of-home care (foster family, residential care) have much greater health care needs than their peers. A systematic literature review was conducted to evaluate organisational health care models for this vulnerable group. METHODS A systematic literature search was undertaken of the following databases: Academic Search Elite, CENTRAL, Cochrane Database of Systematic Reviews, Cinahl, DARE, ERIC, HTA, PsycInfo, Psychology and Behavioural Sciences Collection, PubMed, SocIndex. Randomised and non-randomised controlled trials were to be included. Two pairs of reviewers independently assessed abstracts of the identified published papers. Abstracts meeting the inclusion criteria were ordered in full text. Each article was reviewed independently, by pairs of reviewers. A joint assessment was made based on the inclusion criteria and relevance. Cases of disagreement were resolved by consensus discussion. RESULTS No study with low or medium risk of bias was identified. CONCLUSION In the absence of studies of acceptable quality, it is not possible to assess the impact of organisational models intended to ensure adequate health and dental care for children and adolescents in out-of-home care. Therefore, well-designed follow-up studies should be conducted following the implementation of such models.
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Affiliation(s)
- Tita Mensah
- Faculty of OdontologyMalmö UniversityMalmöSweden
- The Clinic of Paediatric DentistryKarlstadSweden
| | - Anders Hjern
- Clinical EpidemiologyDepartment of MedicineKarolinska InstitutetStockholmSweden
- Centre for Health Equity Studies (CHESS)StockholmSweden
| | - Kickan Håkanson
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU)StockholmSweden
| | - Pia Johansson
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU)StockholmSweden
- Public Health & EconomicsHuddingeSweden
| | - Ann Kristine Jonsson
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU)StockholmSweden
| | - Titti Mattsson
- Faculty of LawHealth Law Research CentreLund UniversityLundSweden
| | - Sofia Tranæus
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU)StockholmSweden
- Health Technology Assessment–Odontology (HTA‐O)Faculty of OdontologyMalmö UniversityMalmöSweden
- Department of Dental MedicineKarolinska InstitutetStockholmSweden
| | - Bo Vinnerljung
- Department of Social WorkStockholm UniversityStockholmSweden
| | - Pernilla Östlund
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU)StockholmSweden
- Health Technology Assessment–Odontology (HTA‐O)Faculty of OdontologyMalmö UniversityMalmöSweden
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